1
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Bao C, Shen S, Gong T, Ji C. A rare case of palmar congenital nevus with sclerodermoid reaction. Clin Case Rep 2024; 12:e8241. [PMID: 38314193 PMCID: PMC10837041 DOI: 10.1002/ccr3.8241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 02/06/2024] Open
Abstract
Palmar congenital nevus with sclerodermoid reaction has not been reported. It has the potential of deep extension following the fibrous bundle. The utilization of slow Mohs or frozen sections with immunohistochemistry staining was recommended.
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Affiliation(s)
- Chengbei Bao
- Department of Dermatology The First Affiliated Hospital of Fujian Medical University Fuzhou China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions The First Affiliated Hospital, Fujian Medical University Fuzhou China
- Fujian Dermatology and Venereology Research Institute The First Affiliated Hospital, Fujian Medical University Fuzhou China
| | - Shuyi Shen
- Department of Dermatology The First Affiliated Hospital of Fujian Medical University Fuzhou China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions The First Affiliated Hospital, Fujian Medical University Fuzhou China
- Fujian Dermatology and Venereology Research Institute The First Affiliated Hospital, Fujian Medical University Fuzhou China
| | - Ting Gong
- Department of Dermatology The First Affiliated Hospital of Fujian Medical University Fuzhou China
- Central Laboratory The First Affiliated Hospital of Fujian Medical University Fuzhou China
| | - Chao Ji
- Department of Dermatology The First Affiliated Hospital of Fujian Medical University Fuzhou China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions The First Affiliated Hospital, Fujian Medical University Fuzhou China
- Fujian Dermatology and Venereology Research Institute The First Affiliated Hospital, Fujian Medical University Fuzhou China
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2
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Neale H, Plumptre I, Belazarian L, Wiss K, Hawryluk EB. Seeking better resolution to magnetic resonance imaging recommendations for infants with congenital melanocytic nevi. J Am Acad Dermatol 2023; 89:e155-e156. [PMID: 37301289 DOI: 10.1016/j.jaad.2023.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 05/09/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Holly Neale
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Isabella Plumptre
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Leah Belazarian
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts; Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Karen Wiss
- Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts; Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Elena B Hawryluk
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Dermatology Program, Department of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts.
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3
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Milani D, Hanlon K, Correa-Selm L, Grichnik JM, Chen WS. Confocal findings of an intradermal nevus in a unique anatomical location: A diagnostic pitfall and histopathologic correlation. JAAD Case Rep 2023; 40:120-122. [PMID: 37766734 PMCID: PMC10520491 DOI: 10.1016/j.jdcr.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Affiliation(s)
- Doniya Milani
- University of South Florida Morsani College of Medicine, Tampa, Florida
| | - Katharine Hanlon
- Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Lilia Correa-Selm
- Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - James M. Grichnik
- Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Wei-Shen Chen
- Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida
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4
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Clements SA, Kelley BF, Rivera L, Greenway HT. Neurotropic melanoma arising from a neurocristic hamartoma. J Cutan Pathol 2023; 50:197-200. [PMID: 36515639 DOI: 10.1111/cup.14378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/30/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
Neurotropic melanoma is a rare type of malignant melanoma with nerve invasion or neural differentiation. Neurocristic cutaneous hamartoma is a rare, benign tumor of the skin and superficial soft tissue that arises from aberrant migration of neural crest cells. We report a rare case of a 74-year-old man with a clinically diagnosed giant congenital nevus of the right mid-back, histopathologically confirmed to be a neurocristic cutaneous hamartoma, who developed neurotropic spindle cell melanoma within the lesion. The patient was treated with serial re-excisions until clear margins were achieved.
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5
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Scharf C, Di Brizzi EV, Licata G, Piccolo V, Argenziano G, Moscarella E. Reflectance confocal microscopy in paediatric patients: Applications and limits. Exp Dermatol 2023; 32:210-213. [PMID: 36264215 DOI: 10.1111/exd.14691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/26/2022] [Accepted: 10/18/2022] [Indexed: 11/30/2022]
Abstract
Reflectance confocal microscopy (RCM) is a non-invasive diagnostic tool extensively studied for adult patients. In this retrospective case series conducted at the Dermatology Unit of the University of Campania, Naples, Italy, all patients under 19 years old who were submitted to RCM from January 2011 to December 2021 where evaluated. The aim of the study was to review the most usual indications and possible benefits that it might add for children. Data collection included 215 patients (86 males and 129 females, mean age: 12). Most of the exams (n = 85; 39.5%) were performed for lesions clinically compatible with Spitz nevi, congenital nevi (n = 50 23,2%) and atypical melanocytic lesions (n = 46; 21%) among which two melanomas were detected. RCM can be an useful instrument when evaluating paediatric patients and may help avoid unnecessary biopsy in most cases, representing an additional instrument to improve diagnostic accuracy.
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Affiliation(s)
- Camila Scharf
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
| | | | - Gaetano Licata
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Vincenzo Piccolo
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
| | | | - Elvira Moscarella
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
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6
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Neale H, Plumptre I, Belazarian L, Wiss K, Hawryluk EB. Central nervous system magnetic resonance imaging abnormalities and neurologic outcomes in pediatric patients with congenital nevi: A 10-year multi-institutional retrospective study. J Am Acad Dermatol 2022; 87:1060-1068. [PMID: 35716834 DOI: 10.1016/j.jaad.2022.05.062] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/28/2022] [Accepted: 05/19/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND High-risk congenital melanocytic nevi (CMN) are associated with abnormalities of the central nervous system (CNS), prompting magnetic resonance imaging (MRI) screening guidelines. OBJECTIVE Describe MRI brain and spine abnormalities in children with CMN and report trends between nevus features, MRI findings, and neurologic outcomes. METHODS Retrospective review of individuals aged ≤18 years with an MRI of the brain and/or spine and at least 1 dermatologist-diagnosed CMN. RESULTS Three hundred fifty-two patients were identified. Forty-six children had CMN that prompted an MRI of the brain and/or spine (50% male, average age at first image, 354.8 days). In these children, 8 (17%) had melanin detected in the CNS, of whom all had >4 CMN. One developed brain melanoma (fatal). In patients without CNS melanin, 4 had concerning imaging. Concerning MRI patients had more neurodevelopmental problems, seizures, neurosurgery, and death than individuals with unremarkable imaging. Three hundred six patients received MRIs for other reasons; none detected melanin. No children with only multiple small CMN (n = 15) had concerning imaging. LIMITATIONS Lack of a control group, cohort size, and retrospective methods. CONCLUSION MRI of the brain and spine is useful for detecting intervenable abnormalities in high-risk children. Healthy infants with few small CMN may not require screening MRI.
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Affiliation(s)
- Holly Neale
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Isabella Plumptre
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Leah Belazarian
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Karen Wiss
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Elena B Hawryluk
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Department of Allergy and Immunology, Dermatology Program, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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7
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Haefliger S, Guitera P, Melhoranse Gouveia B, Colebatch AJ, Scolyer RA, Rtshiladze M, Martin LK. Case report of a challenging medium-sized congenital melanocytic nevus (CMN): Highlighting a role for reflectance confocal microscopy (RCM) for evaluating changing CMN in children. Pediatr Dermatol 2021; 38:1549-1552. [PMID: 34738265 DOI: 10.1111/pde.14846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 3.5-month-old boy presented with a changing medium-sized congenital melanocytic nevus on his leg. Due to atypical features on dermoscopy and reflectance confocal microscopy (RCM), an excision of the area of concern was performed. Histopathology showed many of the pathological features usually associated with a diagnosis of melanoma in situ in older patients, but due to the young age of the patient, absence of mitoses, and the degree of atypia, a diagnosis of a dysplastic compound nevus arising in a congenital compound (predominantly dermal) nevus was favored. In our case, RCM corresponded to histopathology helped target the area of concern and map the clinical and subclinical components to facilitate an optimal biopsy.
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Affiliation(s)
- Stefanie Haefliger
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Sydney Melanoma Diagnostic Centre, Sydney, NSW, Australia.,Department of Dermatology, University Hospital of Berne, Berne, Switzerland
| | - Pascale Guitera
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Sydney Melanoma Diagnostic Centre, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Bruna Melhoranse Gouveia
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Andrew J Colebatch
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Michael Rtshiladze
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Sydney Children's Hospital, Sydney, NSW, Australia
| | - Linda K Martin
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia.,Sydney Children's Hospital, Sydney, NSW, Australia.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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8
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Uzuncakmak TK, Özkoca D, Serdaroğlu S. The Bork-Baykal Phenomenon in Congenital Melanocytic Nevus. Dermatol Pract Concept 2021; 11:e2021058. [PMID: 34414010 DOI: 10.5826/dpc.1103a58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2020] [Indexed: 10/31/2022] Open
Abstract
The Bork-Baykal phenomenon is a new entity that was first reported in large congenital melanocytic nevus 2015 and classified as a specific variant of congenital melanocytic nevus (CMN). Afterward, this rare feature was reported in other skin disorders reflecting the different embryologic developmental periods of the nipple-areola complex (NAC) with the surrounding skin. Preserving of the NAC appears to bowl over the clinicians both in congenital and acquired skin disorders.
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Affiliation(s)
| | - Defne Özkoca
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty Department of Dermatology
| | - Server Serdaroğlu
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty Department of Dermatology
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9
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de la Fouchardière A, Boivin F, Etchevers HC, Macagno N. Cutaneous Melanomas Arising during Childhood: An Overview of the Main Entities. Dermatopathology (Basel) 2021; 8:301-14. [PMID: 34449585 DOI: 10.3390/dermatopathology8030036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 12/28/2022] Open
Abstract
Cutaneous melanomas are exceptional in children and represent a variety of clinical situations, each with a different prognosis. In congenital nevi, the risk of transformation is correlated with the size of the nevus. The most frequent type is lateral transformation, extremely rare before puberty, reminiscent of a superficial spreading melanoma (SSM) ex-nevus. Deep nodular transformation is much rarer, can occur before puberty, and must be distinguished from benign proliferative nodules. Superficial spreading melanoma can also arise within small nevi, which were not visible at birth, usually after puberty, and can reveal a cancer predisposition syndrome (CDKN2A or CDK4 germline mutations). Prognosis is correlated with classical histoprognostic features (mainly Breslow thickness). Spitz tumors are frequent in adolescents and encompass benign (Spitz nevus), intermediate (atypical Spitz tumor), and malignant forms (malignant Spitz tumor). The whole spectrum is characterized by specific morphology with spindled and epithelioid cells, genetic features, and an overall favorable outcome even if a regional lymph node is involved. Nevoid melanomas are rare and difficult to diagnose clinically and histologically. They can arise in late adolescence. Their prognosis is currently not very well ascertained. A small group of melanomas remains unclassified after histological and molecular assessment.
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10
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Houlier A, Pissaloux D, Tirode F, Lopez Ramirez N, Plaschka M, Caramel J, Masse I, de la Fouchardiere A. RASGRF2 gene fusions identified in a variety of melanocytic lesions with distinct morphological features. Pigment Cell Melanoma Res 2021; 34:1074-1083. [PMID: 34310073 DOI: 10.1111/pcmr.13004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/11/2021] [Accepted: 07/16/2021] [Indexed: 11/29/2022]
Abstract
The WHO classification identifies nine classes of melanocytic proliferations according to location, UV exposure, histological, and genetic features. Only a minority of lesions remain unclassified. We describe five cases that harbored either an ERBIN-RASGRF2 or an ATP2B4-RASGRF2 in-frame fusion transcript. These lesions were collected from different studies, unified only by the lack of identifiable known mutations, with a highly variable phenotype. One case was a large abdominal congenital nevus, three were slowly growing pigmented nodules, and the last was an ulcerated nodule arising on the site of a preexisting small nevus, known since childhood. The latter was diagnosed as a 4 mm thick melanoma with loss of BAP1 expression. The four other cases were compound, melanocytic proliferations with an unusual deep pattern of small dense nests of bland melanocytes encased in a fibrous background. The RASGRF2 fusion was confirmed by a break-apart FISH technique. Array CGH performed in three cases found non-recurrent secondary copy number alterations. Follow-up was uneventful. In silico analysis identified a single RASGRF2 fusion in the TCGA pan-cancer database, whereas RASGRF2 variants were stochastically distributed in all cancer subtypes.
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Affiliation(s)
- Aurélie Houlier
- University of Lyon, Université Claude Bernard Lyon 1, CNRS UMR 5286, INSERM U1052, Cancer Research Centre of Lyon, Lyon, France.,Department of Biopathology, Centre Léon Bérard, Lyon, France
| | - Daniel Pissaloux
- University of Lyon, Université Claude Bernard Lyon 1, CNRS UMR 5286, INSERM U1052, Cancer Research Centre of Lyon, Lyon, France.,Department of Biopathology, Centre Léon Bérard, Lyon, France
| | - Franck Tirode
- University of Lyon, Université Claude Bernard Lyon 1, CNRS UMR 5286, INSERM U1052, Cancer Research Centre of Lyon, Lyon, France
| | - Noémie Lopez Ramirez
- University of Lyon, Université Claude Bernard Lyon 1, CNRS UMR 5286, INSERM U1052, Cancer Research Centre of Lyon, Lyon, France
| | - Maud Plaschka
- University of Lyon, Université Claude Bernard Lyon 1, CNRS UMR 5286, INSERM U1052, Cancer Research Centre of Lyon, Lyon, France
| | - Julie Caramel
- University of Lyon, Université Claude Bernard Lyon 1, CNRS UMR 5286, INSERM U1052, Cancer Research Centre of Lyon, Lyon, France
| | - Ingrid Masse
- University of Lyon, Université Claude Bernard Lyon 1, CNRS UMR 5286, INSERM U1052, Cancer Research Centre of Lyon, Lyon, France
| | - Arnaud de la Fouchardiere
- University of Lyon, Université Claude Bernard Lyon 1, CNRS UMR 5286, INSERM U1052, Cancer Research Centre of Lyon, Lyon, France.,Department of Biopathology, Centre Léon Bérard, Lyon, France
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11
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Hu J, Ren M, Cai X, Zhang Y, Lv JJ, Kong YY. Nevus cell aggregates massively occupying parenchyma of an external iliac lymph node: A case report and review of the literature. J Cutan Pathol 2020; 47:1175-1180. [PMID: 32644206 DOI: 10.1111/cup.13805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 11/28/2022]
Abstract
We report a case of nevus cell aggregates (NCAs) in an external iliac lymph node from a patient with a compound congenital nevus in the corresponding drainage skin. Melanocytes in parenchyma were in band, nest-like or nodular fashion, and partly continuous with those in capsule and trabeculae. The largest nodule in parenchyma measured 6.5 mm. Melanocytes mostly exhibited benign appearance identical to cutaneous nevus. A few regions abundant in cells displayed atypical features, including increased nucleo-cytoplasmic ratio, small nucleoli, and occasional mitotic figures. Immunohistochemistry showed that melanocytes stained positive for p16, but negative for HMB-45 and nestin. Ki-67 labeling was less than 1% and reticulin mainly surrounded individual melanocytes. Besides, Vysis melanoma fluorescence in situ hybridization (FISH) plus another 2 probes targeting 9p21(CDKN2A) and 8q24(MYC) showed normal results. The patient is alive without malignant tumor after 52-month follow up. Our case provides a new evidence for the existence of intraparenchymal NCAs in deep lymph node and indicates that melanocytes with some atypical features can occur in nodal nevi. Nevus cells in parenchyma connected to those in capsule and trabeculae are a significant clue to distinguish nodal nevi from metastatic melanomas. Additionally, immunohistochemistry and FISH assay are useful in differential diagnosis.
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Affiliation(s)
- Jue Hu
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Min Ren
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Xu Cai
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yan Zhang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Jiao-Jie Lv
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yun-Yi Kong
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
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12
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Affiliation(s)
- Nathan Fackler
- Department of Dermatology, the University of California, Irvine, California.,Georgetown University, School of Medicine, Washington, DC
| | - Cameron Zachary
- Department of Dermatology, the University of California, Irvine, California.,Georgetown University, School of Medicine, Washington, DC
| | - Dong Joo Kim
- Department of Dermatology, the University of California, Irvine, California
| | - Janellen Smith
- Department of Dermatology, the University of California, Irvine, California
| | - Hege Grande Sarpa
- Department of Dermatology, the University of California, Irvine, California.,Department of Dermatology, Southern California Kaiser Permanente Medical Group, Mission Viejo, California
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13
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Abstract
BACKGROUND: We present to the attention of the medical, dermatological and oncosurgical community data that serves to indicate the indispensability of optimisation of the algorithm and recommendations for diagnosis and surgical treatment of cutaneous melanoma. These recommendations could be referred to different subgroups of patients in different clinical stages as well as to patients with different initial characterisation (histological morphology) of the primary tumours. One step surgery is not a myth, even more, it could prove to be one of the best solutions for some patient collectives with advanced stages of melanoma. CASE REPORT: We present a case of a 74 - year old patient with a congenital medium sized melanocytic nevus, located directly above the lateral part of the elbow joint. In one month and a half, an achromatic nodular formation evolves with a diameter of 2.7 x 2.3 cm, prominent over the skin level, painful by palpation and spontaneously bleeding. By the anamnestic, clinical and dermoscopic findings the patient was diagnosed with nodular melanoma associated with a congenital medium sized melanocytic nevus. A primary excision with a field of safety 0.5 cm in all directions was performed. After confirmation of the primary diagnosis (tumour thickness 8 mm with no ultrasonographic detection of enlarged lymph nodes), seven days later are - excision was performed with an additional field of surgical safety of 1.5 cm in all directions. CONCLUSIONS: In this case remains unclear the following question: For what reason a preoperative high - frequent ultrasonography (HFUS) is not recommended to be used as it will allow only one surgical excision with the elimination of a tumour with a safety field of 2cm in all directions? The enigma about the obstacles preventing such a rational optimisation of the current diagnostic and therapeutic algorithm in patients with melanomas remains unresolved. One step surgery for cutaneous melanoma is widely used in many countries although it continues to be considered as a matter of dispute for some experts. Once again, by a clinical case and the following analysis, we would like to focus the attention of the dermatosurgical community on this crucial and highly significant problem. Innovations are very often resulting from the simplicity of logic, which unfortunately is not always accepted appropriately.
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Affiliation(s)
- Georgi Tchernev
- Medical Institute of Ministry of Interior (MVR-Sofia), Department of Dermatology, Venereology and Dermatologic Surgery, General Skobelev 79, 1606, Sofia, Bulgaria.,Onkoderma-Policlinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606 Sofia, Bulgaria
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14
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Porubsky C, Teer JK, Zhang Y, Deschaine M, Sondak VK, Messina JL. Genomic analysis of a case of agminated Spitz nevi and congenital-pattern nevi arising in extensive nevus spilus. J Cutan Pathol 2017; 45:180-183. [PMID: 29210482 DOI: 10.1111/cup.13082] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/02/2017] [Accepted: 11/17/2017] [Indexed: 12/30/2022]
Abstract
Nevus spilus is a melanocytic neoplasm characterized by a tan macular background punctuated by multiple hyperpigmented macules or papules that represent various types of nevi. These include junctional and compound nevi, Spitz nevi, and rarely blue nevi. We report a unique case of widespread, multiple nevi spili giving rise to agminated Spitz nevi and congenital-pattern compound nevi. We performed genetic analysis to further characterize the mutational profile of this rare entity.
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Affiliation(s)
- Caitlin Porubsky
- Department of Dermatology, PCOM Mednet/North Fulton Hospital Medical Campus, Roswell, Georgia
| | - Jamie K Teer
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida.,Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida
| | - Yonghong Zhang
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
| | - Maria Deschaine
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida
| | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Jane L Messina
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida.,Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
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15
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Tchernev G, Patterson JW, Bakardzhiev I, Lotti T, Lotti J, França K, Batashki A, Wollina U. Late Onset Achromatic Melanoma Arising in a Giant Congenital Melanocytic Nevus. Open Access Maced J Med Sci 2017; 5:533-534. [PMID: 28785352 PMCID: PMC5535677 DOI: 10.3889/oamjms.2017.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 03/29/2017] [Accepted: 04/03/2017] [Indexed: 11/14/2022] Open
Abstract
A 61-year-old woman, with a lifelong history of a giant congenital melanocytic nevus in the occipital region with secondary development of giant melanoma is presented. Surgical excision was performed, and the histopathological evaluation confirmed the diagnosis of Giant Malignant Melanoma (GMM) with a maximum tumour thickness of 16 mm. Nowadays, there is tremendous uncertainty regarding how giant congenital melanocytic nevi (GCMN) should be treated. The standard approach to patients with late onset giant congenital melanocytic nevi (GCMN is based on two main considerations: (1) obtain an acceptable cosmetic results with the purpose to decrease the psychosocial inconvenience to each patient, and (2) to attempt to minimise the risk of development of malignant transformation. Unfortunately complete surgical removal of the GCMN is usually difficult and very often impossible without subsequent functional or cosmetic mutilations.
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Affiliation(s)
- Georgi Tchernev
- Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, and Onkoderma Polyclinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
| | - James W Patterson
- Departments of Pathology and Dermatology, University of Virginia Health System, Hospital Expansion, 3rd Floor, 1215 Lee Street, Charlottesville, VA, USA
| | - Ilko Bakardzhiev
- Medical College, Medical University of Varna, Varna 9000, Bulgaria
| | - Torello Lotti
- Department of Biotechnology, Delft University of Technology, 2628 BC, Delft, The Netherlands
| | - Jacopo Lotti
- Department of Nuclear, Subnuclear and Radiation Physics, University of Rome "G. Marconi", Rome, Italy
| | - Katlein França
- Institute for Bioethics & Health Policy; Department of Dermatology & Cutaneous Surgery; Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine - Miami, FL, USA
| | - Atanas Batashki
- Department of Special Surgery, Medical University of Plovdiv, bul. "Peshtersko shose" Nr 66, 4000, Plovdiv, Bulgaria
| | - Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany
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Soteropulos CE, Mountziaris PM, Adetayo OA. Pilomatrixoma Arising Juxtaposed to Congenital Melanocytic Nevi: Concern for Malignant Degeneration? A Previously Unreported Association. Eplasty 2016; 16:ic30. [PMID: 27563370 PMCID: PMC4980805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Carol. E Soteropulos
- Division of Plastic and Reconstructive Surgery, Albany Medical Center, Albany, NY,Correspondence:
| | | | - Oluwaseun A. Adetayo
- Division of Plastic and Reconstructive Surgery, Albany Medical Center, Albany, NY
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Agarwal P, Nambiyar K, Manju Kaushal, Bhardwaj M. Primary Malignant Melanoma of Pleura: A Case Report and Literature Review. Diagn Cytopathol 2016; 44:648-52. [PMID: 27164972 DOI: 10.1002/dc.23497] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 04/19/2016] [Accepted: 04/23/2016] [Indexed: 12/19/2022]
Abstract
Malignant melanoma is one of the most aggressive and treatment resistant skin cancers. India enjoys a low incidence of melanoma, and age specific incidence rates for cutaneous malignant melanoma (CMM) are being less than 0.5 per 1,000,000. This could be due to under-reporting of melanoma on account of a low index of suspicion by clinicians and pathologists alike. Most common site for origin of primary melanoma is skin, accounting for about 91.2% of all reported primary malignant melanoma cases. Other primary sites are relatively uncommon. Primary pleural melanoma is a very rare tumor and to the best of our knowledge, only seven cases have been reported so far worldwide. We hereby discuss a new case, only second from India. Our patient also had coexistent congenital hairy nevus, an unusual association also noted in two previously reported cases. Excluding primary cutaneous melanoma with pleural metastasis was a diagnostic challenge in this case but multiple cutaneous biopsies together with clinical and findings helped us arrive at this unusual diagnosis. Unfortunately, the patient succumbed to his illness. Diagn. Cytopathol. 2016;44:648-652. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Poojan Agarwal
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
| | | | - Manju Kaushal
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
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Richey P, Radfar A, Kirkorian AY. Blue areas on dermoscopy of a congenital nevus with Meyerson phenomenon. J Am Acad Dermatol 2015; 73:e161-3. [PMID: 26475555 DOI: 10.1016/j.jaad.2015.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 06/24/2015] [Accepted: 07/03/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Patricia Richey
- Georgetown University School of Medicine, Washington, District of Columbia
| | - Arash Radfar
- Department of Dermatology, Georgetown University-Washington Hospital Center, Washington, District of Columbia
| | - A Yasmine Kirkorian
- Division of Dermatology, Children's National Health System, Washington, District of Columbia; Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
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Alomari AK, Glusac EJ, Choi J, Hui P, Seeley EH, Caprioli RM, Watsky KL, Urban J, Lazova R. Congenital nevi versus metastatic melanoma in a newborn to a mother with malignant melanoma - diagnosis supported by sex chromosome analysis and Imaging Mass Spectrometry. J Cutan Pathol 2015; 42:757-64. [PMID: 25989266 DOI: 10.1111/cup.12523] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/23/2014] [Accepted: 01/20/2015] [Indexed: 12/16/2023]
Abstract
A 37-year-old pregnant woman presented with a 2-cm irregular reddish nodule on her left upper arm during pregnancy. A biopsy from the lesion showed a 2.2-mm thick malignant melanoma with intravascular invasion, 25 mitosis/mm(2) and no ulceration. Following induction of labor, the patient underwent re-excision with sentinel lymph node biopsy. This showed no residual melanoma and no lymph node metastasis. The newborn boy had multiple pigmented lesions on the trunk, some of which were large and irregular. Two were biopsied and histologic examination showed dense dermal proliferation of medium sized melanocytes with multiple mitotic figures and no maturation with their descent into the dermis, raising suspicion of transplacental metastases. Examination of the placenta failed to show metastatic lesions. Multiplex polymerase chain reaction (PCR)-based genotyping, including testing for amelogenin locus for sex chromosome determination, demonstrated the presence of Y chromosome material in the melanocytes of the newborn's lesions excluding maternal origin. A diagnosis of congenital nevi was rendered. Subsequently, Imaging Mass Spectrometric analysis of the mother's lesion showed proteomic signature expression indicative of malignant melanoma, whereas the two lesions in the newborn showed changes indicative of nevi. This case demonstrates the utility of genotyping and Mass Spectrometry analysis in this challenging clinical scenario.
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Affiliation(s)
- Ahmed K Alomari
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Earl J Glusac
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Jennifer Choi
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Pei Hui
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Erin H Seeley
- Mass Spectrometry Research Center, Vanderbilt University, Nashville, TN, USA
| | - Richard M Caprioli
- Mass Spectrometry Research Center, Vanderbilt University, Nashville, TN, USA
| | - Kalman L Watsky
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Jennifer Urban
- Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Rossitza Lazova
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
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Boujoual M, Jabouirik F. [The giant congenital nevus]. Pan Afr Med J 2014; 18:48. [PMID: 25368737 PMCID: PMC4215381 DOI: 10.11604/pamj.2014.18.48.4468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 05/10/2014] [Indexed: 11/11/2022] Open
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van Engen-van Grunsven ACH, Kusters-Vandevelde H, Groenen PJTA, Blokx WAM. Update on Molecular Pathology of Cutaneous Melanocytic Lesions: What is New in Diagnosis and Molecular Testing for Treatment? Front Med (Lausanne) 2014; 1:39. [PMID: 25593912 PMCID: PMC4291896 DOI: 10.3389/fmed.2014.00039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 08/26/2014] [Indexed: 01/01/2023] Open
Abstract
In this article, we give an update on recent findings regarding molecular pathology in cutaneous melanocytic tumors. The focus lies on use of genetics in the diagnosis of distinct subtypes of spitzoid tumors that are often characterized by specific phenotypic–genotypic alterations that can frequently be recognized by adequate histological examination. Typical illustrating cases are given in order to increase recognition of these lesions in daily dermatopathology practice. New molecular findings in the pathogenesis of congenital melanocytic tumors and neurocutaneous melanosis are reviewed. In addition, use of mutation analysis in the differential diagnosis of melanoma metastasis is discussed. Finally, application of mutation analysis in targeted therapy in advanced melanoma with advantages of new techniques such as next generation sequencing is described.
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Affiliation(s)
| | | | | | - Willeke A M Blokx
- Department of Pathology, Radboud University Medical Center , Nijmegen , Netherlands
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Abstract
A case of balloon cell melanoma encountered in a primary care skin cancer practice in Melbourne, Australia is presented. The presenting lesion was 6 mm in diameter, ulcerated, non-pigmented and without any algorithmic clues to melanoma. However the presence of terminal hairs caused the clinician to suspect that it was melanocytic. The lesion was reported as a balloon cell melanoma, Clark level 4, Breslow thickness 2 mm with a mitotic index of 4 per square mm. This is an extremely rare melanoma subtype. Author DW has encountered only two cases in a career involving in excess of one million signed out dermatopathology reports. A search of the literature has not discovered any previously published dermatoscopy images of a balloon cell melanoma.
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Affiliation(s)
- Mike Inskip
- Sun Patrol Skin Cancer Clinic, Berwick, Australia
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